UK leads way as flu activity rises in Europe

Dec 16, 2010 (CIDRAP News) – The United Kingdom is on the leading edge of an increase in influenza activity in Europe, with 57 respiratory disease outbreaks and an increase in critically ill patients and deaths reported in the country last week, according to the UK Health Protection Agency (HPA).

In its weekly flu update, the HPA said the rate of medical visits for flu-like illness exceeded baseline levels, reaching 34.6 per 100,000 population. The 2009 H1N1 and influenza B viruses are predominating so far this season, with only a few H3N2 viruses identified, the agency reported.

Flu activity is also rising across Europe, with increasing transmission in 11 countries, the European Centre For Disease Prevention and Control (ECDC) said in a Eurosurveillance report today.

In the United Kingdom, of 17 people who have died of flu-related causes in the past 3 months, 7 deaths were reported last week, the two latest HPA reports show. Fourteen of the deaths were attributed to the 2009 H1N1 virus. All those who died were younger than 65, and 8 were in high-risk groups, though none were pregnant.

Seventeen critically ill patients have received extracorporeal membrane oxygenation (ECMO) (the use of an artificial lung), out of 22 patients referred for it, the HPA reported. Four of the 17 were pregnant women.

Meanwhile, press reports suggested that flu activity in parts of Britain now is worse than at the peak of the 2009 pandemic, but a health official said the flu situation is no worse than in past years.

The Independent newspaper reported today that northwestern England has seen a surge of hospitalized flu patients in the past 10 days and that the numbers are higher than at the peak of the pandemic. It said five deaths were reported in the region yesterday. The story also quoted intensive care specialists as saying that the National Health Service is under more pressure than it was a year ago.

In addition, the newspaper said public health specialists called the flu situation in northeastern England as bad as or worse than at the peak of the pandemic. The number of severely ill patients has surprised specialists, because monitoring has indicated low levels of H1N1 flu in the community, the story said.

Bob Winter, president of the UK Intensive Care Society, told the newspaper, "Something different is happening this year. The last 10 days have seen a sudden surge of activity. The numbers in intensive care are increasing across the UK. . . . We have told the Department of Health that this is emerging as a serious issue."

However, Dame Sally Davies, interim chief medical officer for England, told the BBC that flu is not more prevalent now than at the same time in previous years, according to a UK Press Association report today.

Davies added that the 35 medical visits for flu-like illness per 100,000 people in the past week is up from 13 per 100,000 the week before, and said, "The issue I'm very concerned about is we're not getting everyone at risk—including pregnant women—vaccinated."

The HPA report said flu vaccine uptake in England as of about 2 weeks ago was 67.2% for people older than 65 and 41.6% for high-risk people younger than 65.

Of 355 respiratory samples that tested positive for flu last week, 271 (76.3%) were the 2009 H1N1 virus, 77 (21.7%) were type B, and 7 (2.0%) were type A strains that were not subtyped, the HPA reported.

Similarly, today's Eurosurveillance report from the ECDC said that most of the flu viruses circulating in Europe are H1N1 and influenza B.

"Although the majority of cases in the UK are mild, a significant number of severe hospitalized cases and several deaths have occurred," the report said.

"In the past epidemics have most often progressed from west to east in Europe," the statement said, adding that limited time remains for public health and clinical interventions to reduce the impact of flu this winter. It said there is strong evidence that this year's vaccine will be "highly effective" against the H1N1 virus.